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Tabel biaya Pasian Hernia Ingunalis Lateralis (HIL) Dextra Responibilis Oktober-Desember 2012 RSUD Kota Bandung

No TGL BAG NAMA PASIEN DOKTER NOMOR NAMA OBAT/ALKES JML HARGA TOTAL HRG TOTAL

1 10-Oct BEDAH YAYAT H AP 20284 OPTIME 2/0 TUPPER 1 114,180 114,180 1,845,608

3 MD.526057 IV CAT-SURFLO 20 1 11,136 11,136 SKM

10/10-14/10 INFUS SET 0I-34 1 13,860 13,860

HIL Dex Reponible RINGER LAKTAT-WB 2 5,220 10,440

11-Oct BEDAH MNS 20337 CEFTRIAXON INJ 1 G BERNO 2 6,970 13,940

2 KETOROLAC 30MG INJ DEXA 2 8,853 17,706

SPUIT 1 CC INS TERUMO 1 3,010 3,010

SPUIT 3 CC TERUMO 2 1,122 2,244


RINGER LAKTAT-WB 3 5,220 15,660

GLUKOSE 5 %-WD 2 4,247 8,494

11-Oct OK YUDHIE 22660 PISAU BEDAH 10 -AESCULAP 1 2,072 2,072

1 SARUNG TANGAN TERUGLOVE 7.5 10 9,009 90,090

MASKER TIE ON SUREPLUS 2 792 1,584

TOPI OPERASI 2 792 1,584

CROMIC 3/0 HR26 SHARPOINT 1 61,710 61,710

NYLON 4/0 D5 18 SHARPOINT 1 56,100 56,100

PROANES INJ 1 79,200 79,200

NOTRIXUM ASKIN 1 42,120 42,120

KETOROLAC INJ 30-BRN 3 8,911 26,733

TRAMADOL INJ.-INF 1 7,244 7,244





ONDANSETRON 8MG INJ 1 15,523 15,523

SURGICRIL 2/0 1 62,645 62,645

POLYESTER 1 2 48,400 96,800

FC 18 GR GOLD RUSCH 1 20,493 20,493

URINE BAG COSMOMED 1 5,280 5,280

BUVIPACAIN INJEKSI 1 23,760 23,760

SPINOCAN 25 G 1 36,366 36,366

WIDAHES 130 ASKIN 1 61,800 61,800

PRONALGES SUPPO ASKIN 1 5,760 5,760

Prostigmin INJ 2 15,500 31,000

DEXAMETASON INJ.-LUCAS 2 1,386 2,772

SILK 2/0 SHARPOINT 1 50,490 50,490

FENTANYL INJ-KF 1 36,960 36,960

12-Oct BEDAH ANDY 22409 CEFTRIAXON INJ 1 G BERNO 2 6,970 13,940

1 KETOROLAC INJ 30-BRN 2 8,911 17,822



FC 18 GR GOLD RUSCH 1 20,493 20,493



FC 16 GR GOLD RUSCH 1 14,355 14,355





14-Oct BEDAH ANDY 22364 AMOKSISILIN 500 KF 15 444 6,660

ANIOS ADP 55,000

IODINE 150 30,000

WASH SCRUB 150 37,500

KASA 5 55,000

SILK 2/0 1 4,200

ALKOHOL 100 5,000

JARUM/PLESTER 1 15,000

ARP 1 25,500

LINAPEN 1 17,000

O2 0.5 4,400

N2O 0.25 31,500

ISOFLURENT 50 265,000

BHP 128,400

14-Oct 6383 AS. MEFENAMAT 500-KF 15 2,500

1,848,1082 .16/10 BEDAH WAWAN ANDY 20614 NYLON 3/0 D5 24 SHARPOINT 1 56,100 56,100 1,873,626

3 MD 133059 INFUS SET 0I-34 1 13,860 13,860 SKM

16/10-19/10 IV CAT-SURFLO 20 1 11,136 11,136

HIL D Ripondible RINGER LAKTAT-WB 1 5,220 5,220

optime 2/0 18s30j 1 95,040 95,040

CROMIC PTG 3/0 1 59,136 59,136

17-Oct BEDAH ANDY 22222 CEFOTAXIM INJ 1 G-HXP 2 4,895 9,790



GLUKOSE 5 %-WD 1 4,247 4,247

SPUIT 1 CC TUB TERUMO 1 2,178 2,178



17-Oct OK YUDHIE 22174 PISAU BEDAH 15-AESCULAP 1 2,700 2,700





PROANES INJ 1 79,200 79,200








ETT 6,5 RUSCH 1 77,933 77,933


ATROPIN INJ-ETHICA 1 3,049 3,049



GREEN POLYESTER 2 86,724 173,448

18-Oct BEDAH ANDY 22254 CEFOTAXIM INJ 1 G-BERNO 2 4,801 9,602






ANIOS ADP 55,000

IODINE 150 30,000


KASA SEDANG 2 22,000

KASA X RAY 2 26,800

CROMIC 2/0 1 9,800

ARP 1 25,500

JARUM 1 15,000

ALKOHOL 100 5,000

LINAPEN 1 17,000

O2 0.4 4,400

N2O 0.25 31,500


BHP 88,500

1,873,626

3 2-Nov BEDAH AIM ABDUL ANDY ANIOS ADP 55,000 748,700

MD.978257 SKM

02/11-07/11 IODINE 150 30,000

HIL d reponible WASH SCRUB 150 37,500

KASA 2 22,000

KASA X RAY 2 26,800

ALKOHOL 100 5,000

CROMIC 2/0 1 9,800

ARP 1 25,500


LINAPEN 1 17,000

O2 0.5 4,400

N2O 0.25 31,500


BHP 151,200

748,7004 31-Oct BEDAH YAYAN MN 7213 IV CAT-SURFLO 20 1 11,136 11,136 1,508,163

3 MD.699858 RINGER LAKTAT-WB 1 5,220 5,220 JAMKESMAS

31/10-04/11 INFUS SET 0I-34 1 13,860 13,860

Hil D Reponible SPUIT 5 CC TERUMO 1 1,848 1,848

1-Nov OK MARUHUM 23236 PISAU BEDAH 10 -AESCULAP 1 2,072 2,072





SARUNG TANGAN TERUGLOVE 7.5 1 9,009 9,009





TRAMADOL INJ BERNO 2 7,883 15,766

ONDANSENTRON INJ 8 MG INDO 1 10,032 10,032


SPINOCAN 25 G 1 36,366 36,366


INFUS SET 0I-34 1 13,860 13,860

IV CAT-SURFLO 20 1 11,136 11,136

WIDAHES 130 ASKIN 1 61,800 61,800

AS. TRANEKSAMAT INJ 250 MG-BRN 2 3,280 6,560


1-Nov BEDAH ANDY 23258 CEFTRIAXON INJ 1 G-HXP 1 7,983 7,983

1 GENTAMYCIN INJ.-INF 2 4,032 8,064



GLUKOSE 5 %-WD 2 4,247 8,494




1-Nov BEDAH ANDY 7173 SURGICRIL 2/0 1 62,645 62,645

1 NYLON 3/0 D5 24 SHARPOINT 1 56,100 56,100






PARASETAMOL MARIN 3 120 360

2-Nov BEDAH ANDY 23143 KAPTOPRIL 25 ASKIN 9 114 1,026






INFUS SET 0I-34 1 13,860 13,860

IV CAT-SURFLO 20 1 11,136 11,136

4-Nov BEDAH ANDY 23053 AMOKSISILIN 500 INF 15 444 6,660

ANIOS ADP 55,000

IODINE 150 30,000


KASA 3 33,000

KASA X RAY 3 40,200

ALKOHOL 100 5,000

SILK 2/0 1/2 2,100

ARP 1 25,500

CROMIC 2/0 1/2 4,900


LINAPEN 1 17,000

O2 0.5 4,400

N2O 0.25 31,500


BHP 136,800

1,508,1635 28-Nov BEDAH REDI MN 50623 SURGICRIL 3/0 1 58,960 58,960 1,807,360

3 MD.432559 optime 4/0 18s15f 1 95,040 95,040

28/11-02/12 IV CAT-SURFLO 20 1 11,136 11,136

HIL d reponible INFUS SET 0I-34 1 13,860 13,860


IV CAT-SURFLO 22 1 11,136 11,136

29-Nov OK YUDHIE 25088 PISAU BEDAH 10 -AESCULAP 1 2,072 2,072




CROMIC 2-0 TAPER SURGIVENT 1 61,710 61,710


PROANES INJ 1 79,200 79,200









SURGICRIL 2/0 1 62,645 62,645


CEFOTAXIM INJ 1 G-HXP 1 4,895 4,895



29-Nov BEDAH SIMAMORA 50687 CEFOTAXIM INJ 1 G-HXP 2 4,895 9,790



GLUKOSE 5 %-WD 2 4,247 8,494




30-Nov BEDAH ANDY 25225 CEFOTAXIM INJ 1 G-HXP 2 4,895 9,790




OBH 100 ML TDR 1 2,352 2,352

1-Dec BEDAH ANDY 25310 CEFOTAXIM INJ 1 G-HXP 2 4,895 9,790





INFUS SET 0I-34 1 13,860 13,860

02/12 BEDAH ANDY 25407 AMOKSISILIN 500 TABLET BERNO 8 446 3,568

ANIOS ADP 55,000

IODINE 100 20,000


KASA 3 14,700


CROMIC 2/0 1/2 4,900

SILK 2/0 1/2 2,100

LINAPEN 1 17,000

ARP 1 25,500

JARUM 1 15,000

ALKOHOL 50 2,500

O2 0.5 4,400

N2O 0.25 31,500


BHP 107,700

1,807,360

6 28/11 BEDAH SANJAYA ANDY ANIOS ADP 55,000 620,550MD.716559 JAMKESMAS

30/11-02/12 IODINE 75 15,000

HIL REPONIBLE WASH SCRUB 75 18,750

KASA 2 22,000

KASA SILVER 2 9,800

LINAPEN 1 17,000

FORMALIN 10 500

ARP 1 25,500

JARUM 1 15,000

ALKOHOL 50 2,500

O2 0.5 4,400

N2O 0.25 31,500


BHP 48,600

BEDAH MSN 585 CIFOTAXIM INJ 1 G-BERNO 1RINGER LAKTAT-WB 1GLUKOSE 5% TERUMO 1SPUTI 5 CC TERUMO 1SPUTI 3 CC TERUMO 1SPUTI 1 CC INS TERUMO 1BUFFECT SIR. 1 37,000

620,5507 14/12 BEDAH UTEP ANDY ANIOS ADP 55,000 1,605,700

MD.500561 JAMKESMAS

14/12-19/12 IODINE 150 30,000

HIL D Reponible WASH SCRUB 150 37,500


CROMIC 2/0 1 9,800

LINAPEN 1 17,000

ARP 1 25,500

JARUM 1 15,000

ALKOHOL 100 5,000

O2 0.5 4,400

N2O 0.25 31,500


BHP 144,000BEDAH MSN 26325 INFUS SET DWS- TERUMO 1

IV CAT-SURFLO 20 1

RINGER LAKTAT-WB 1 30,000

OK MSN 27195 PISAU BEDAH 10 -AESCULAP 1

SARUNG TANGAN T GLOVE 7 4

MASKER TIE ON SUREPLUS 2

TOPI OPERASI 2

CATGUT CROMIC NO. 2/0 1

SARUNG TANGAN T GLOVE 7 1

SPUIT 5 CC TERUMO 2

SPUIT 3 CC TERUMO 1

BUVIPACAIN INJEKSI 1

KETOROLAC 30MG INJ DEXA 2

TRAMADOL INJ BERNO 2

ONDANSETRON 8MG INJ BERNO 1

RINGER LAKTAT-WB 1

SPINOCAN 25 G 1

Pronalges SUPP 100 1

POLYESTER 1 2

SURGICRIL 2/0 1

WIDAHES 130 ASKIN 1

AS. TRANEKSAMAT INJ 250 MG-BRN 2

FC 18 GR FLEXYCATH 1

URINE BAG COSMOMED 1

FENTANYL INJ-KF 1 603,000

BEDAH ANDY 26404 FC 16 GR FLEXYCATH 1

URINE BAG COSMOMED 1 24,000

1,605,7008 28/11 BEDAH HERRY ANDY ANIOS ADP 55,000 973,400

MD.211859 SKM28/11-02/12 IODINE 100 20,000

HIL d reponible WASH SCRUB 100 25,000

KASA 3 14,700


CROMIC 2/0 1/2 4,900

SILK 2/0 1/2 2,100

LINAPEN 1 17,000

ARP 1 25,500

JARUM 1 15,000

ALKOHOL 50 2,500

O2 0.5 4,400

N2O 0.25 31,500


BHP 105,300

BEDAH MNS 3021 CEFTRIAXON INJ 1 G-HXP 2

SPUIT 10 CC TERUMO 2

TERANOL INJ 30 MG 2

CEFOTAXIM INJ 1 G-BERNO 2

SPUIT 5 CC TERUMO 2

SPUIT 3 CC TERUMO 3

RINGER LAKTAT-WB 2 98,500

973,4009 23/10 BEDAH KANDI AP 6679 INFUS SET 0I-34 1 13,860 13,860 1,692,716

3 MD.792759 IV CAT-SURFLO 20 1 11,136 11,136 JAMKESMAS

23/10-26/10 RINGER LAKTAT-WB 1 5,220 5,220

Reponible

24/10 BEDAH ANDY 23795 NYLON 3/0 D5 24 SHARPOINT 1 56,100 56,100

1 CROMIC 3/0 HR26 SHARPOINT 1 61,710 61,710

optime 2/0 18s30j 1 95,040 95,040

24/10 OK YUDHIE 23620 PISAU BEDAH 10 -AESCULAP 1 2,072 2,072






PROANES INJ 1 79,200 79,200










NACL 0.9% 500 ML-WB 2 5,587 11,174


WIDAHES 130 ASKIN 1 61,800 61,800

SPINOCAN 25 G 1 36,366 36,366




.24/10 BEDAH ANDY 6717 KETOROLAC INJ 30-BRN 2 11,220 22,440

2 CEFTRIAXON INJ 1 G-HXP 1 7,983 7,983




GLUKOSE 5 %-WD 1 4,247 4,247


25/10 BEDAH ANDY 23686 CEFTRIAXON INJ 1 G BERNO 2 6,970 13,940




26/10 BEDAH ANDY 23582 AMOKSISILIN 500 KF 15 444 6,660

ANIOS ADP 55,000

IODINE 150 30,000



KASA SILVER 3 14,700

CROMIC 2/0 1/2 4,900

ALKOHOL 100 5,000

ARP 1 25,500

JARUM 1 15,000

LINAPEN 1 17,000

O2 0.5 4,400

N2O 0.25 31,500


BHP 66,600

1,692,716 10 24/10 BEDAH HENDI ANDY 6927 INFUS SET 0I-34 1 13,860 13,860 1,898,070

3 MD 424658 IV CAT-SURFLO 20 1 11,136 11,136 SKM

24/10-28/10 SPUIT 5 CC TERUMO 1 1,848 1,848

24/10 BEDAH MN 6726 SURGICRIL 2/0 1 62,645 62,645

3 SURGICRIL MONOFILAMEN 4/0 1 59,601 59,601


IV CAT-SURFLO 20 1 11,136 11,136

INFUS SET 0I-34 1 13,860 13,860

25/10 BEDAH SIMAMORA 6792 CEFTRIAXON INJ 1 G BERNO 1 6,970 6,970

2 CIPROFLOXACIN TAB 500 BERNO 10 318 3,180



GLUKOSE 5 %-WD 2 4,247 8,494










PROANES INJ 1 79,200 79,200










FC 18 GR GOLD RUSCH 1 20,493 20,493


WIDAHES 130 ASKIN 1 61,800 61,800


SPINOCAN 25 G 1 36,366 36,366




26/10 BEDAH ANDY 23569 CEFTRIAXON INJ 1 G-HXP 1 7,983 7,983











ANIOS ADP 55,000

IODINE 150 30,000



KASA X RAY 2 26,800

SILK 2/0 1 4,200

ARP 1 25,500

JARUM 1 15,000

ALKOHOL 100 5,000

LINAPEN 1 17,000

O2 0.4 4,400

N2O 0.25 31,500


BHP 109,500

1,898,07011 27/11 BEDAH AYU ANDY ANIOS ADP 55,000 242,200

MD.686559 SKM

27/11-29/11 IODINE 100

HIL D Responibilis WASH SCRUB 100 ,,

KASA SEDANG 3 33,000 CROMIC 2/0 1 9,800 ARP 1 25,500 JARUM 1 15,000 LINAPEN 1 17,000 O2 0.4 4,400N2O 0.25 31,500ISOFLURENT 100

BHP 51,000 242,200

12 12-Oct BEDAH EKA ANDY 20385 NYLON 3/0 D5 24 SHARPOINT 1 56,100 56,100 2,177,2922 MD 611159 optime 2/0 18s30j 1 95,040 95,040 SKM

12/10-16/10 CROMIC 3/0 1 58,212 58,212

Hel s reponible INFUS SET 0I-34 1 13,860 13,860

IV CAT-SURFLO 20 1 11,136 11,136



13-Oct OK YUDHIE 22487 CROMIC 2/0 JABAR MEDIKA 1 61,710 61,710

1 PISAU BEDAH 10 -AESCULAP 1 2,072 2,072













ASERING 3 16,622 49,866

TOTOFUSIN OPS ASKIN 1 44,400 44,400


TICRON 1 3113 71 3 74,844 224,532

NACL 0.9% 500 ML-WB 1 5,587 5,587

SARUNG TANGAN TERUGLOVE 7 2 9,009 18,018

SPINOCAN 25 G 1 36,366 36,366

EPHEDRIN INJ-ETHICA 2 14,520 29,040


PETHIDIN INJ-KF 1 14,390 14,390







GLUKOSE 5 %-WD 1 4,247 4,247






15-Oct BEDAH ANDY 22120 CEFOTAXIM INJ 1 G-HXP 2 4,895 9,790





AMOKSISILIN 500 KF 15 444 6,660

ANIOS ADP 55,000

IODINE 150 30,000



CROMIC 2/0 1 9,800

ARP 1 25,500

JARUM 1 15,000

L1NAPEN 1 17,000

ALKOHOL 100 5,000

O2 0.4 4,400

N2O 0.25 31,500


BHP 128,400

14-Oct ANDI 22367 MIKONAZOL CR-KF 1 4,000 4,000

14-Oct ANDI 20576 SPUIT 3 CC TERUMO 4

SPUIT 5 CC TERUMO 1

RINGER LAKTAT-WB 1

SPUIT 1 CC TUB TERUMO 1

AMPISILIN INJ BERNO 1

GENTAMYCIN INJ.-INF 1 25,500

2,177,29213 1-Nov BEDAH NUNU ANDI 7263 RATAN INJ ASKIN 2 1,200 2,400 92,646


01/11-03/11 OTSU Y SET 1 11,484 11,484

Hil S reponible IV CAT-SURFLO 20 1 11,136 11,136


2-Nov BEDAH ANDI 7500 RINGER LAKTAT-WB 2 5,220 10,440

BHP 48,600

92,646

14 12-Dec BEDAH WIWI MN 26209 SURGICRIL 2/0 1 62,645 62,645 1,560,972

3 MD.413659 NYLON 3/0 D5 24 SHARPOINT 1 56,100 56,100 JAMKESMAS

12/12-16/12 INFUS SET 0I-34 1 13,860 13,860

HIL S REPONIBLE IV CAT-SURFLO 20 1 11,136 11,136


13-Dec BEDAH MS 25950 CEFOTAXIM INJ 1 G-HXP 1 4,895 4,895

1 SPUIT 1 CC TUB TERUMO 1 2,178 2,178


13-Dec OK SIMMAMORA 25958 GREEN POLYESTER 2 86,724 173,448

1 PISAU BEDAH 10 -AESCULAP 1 2,072 2,072

SARUNG TANGAN GAMEX 7 .5 4 9,900 39,600











SPINOCAN 25 G 1 36,366 36,366




FC 18 GR GOLD RUSCH 1 14,256 14,256


SILK 2/0 Jabar medika 1 50,490 50,490


MILOZ INJ 15 ASKIN 1 14,310 14,310

13-Dec BEDAH SIMMAMORA 25987 CEFOTAXIM INJ 1 G-HXP 2 4,895 9,790



GLUKOSE 5 %-WD 2 4,247 8,494








14-Dec BEDAH ANDY 27167 FOLIC ACID TAB 1 MG MARIN 3 48 144

1 CA GLUKONAS INJ 3 12,524 37,572

NASAL OKSIGEN DWS PASCHO 1 21,600 21,600






ANIOS ADP 55,000

IODINE 150 30,000



SILK 2/0 1/2 2,100

LINAPEN 1 17,000

ARP 1 25,500

JARUM 1 15,000

ALKOHOL 100 5,000

O2 0.5 4,400

N2O 0.25 31,500


BHP 107,700

1,560,972TOTAL 18,647,003Rata-rata 1,331,928

Tabel biaya Pasian Fibro Adenoma MamaeOktober-Desember 2012 RSUD Kota Bandung

No TGL BAG NAMA PASIEN DOKTER NOMOR NAMA OBAT/ALKES JML HARGA TOTAL HRG TOTAL1 19-Oct BEDAH AI HIRIN ANDY 20813 NYLON 4/0 D5 18 SHARPOINT 1 56,100 56,100 1,342,838

2 MD 032459 INFUS SET 0I-34 1 13,860 13,860 SKM19/10-24/10 IV CAT-SURFLO 20 1 11,136 11,136

Sus fam D SPUIT 5 CC TERUMO 1 1,848 1,848







PROANES INJ 1 79,200 79,200









PENROSE DRAIN 5/8 1 78,000 78,000




20-Oct OK YUDHIE 23809 CEFTRIAXON INJ 1 G BERNO 1 6,970 6,970



GLUKOSE 5 %-WD 1 4,247 4,247















ANIOS ADP 55,000

IODINE 100 20,000



CROMIC 2/0 1 9,800

FORMALIN 10 500

ARP 1 25,500

JARUM 1 15,000

ALKOHOL 100 5,000

LINAPEN 1 17,000

O2 0.4 4,400

N2O 0.25 31,500


BHP 141,600

1,342,8382 6-Nov BEDAH SOPIA ANDY 28042 NYLON 4/0 D5 18 SHARPOINT 1 56,100 56,100 1,315,764

2 MD 675059 INFUS SET 0I-34 1 13,860 13,860 JAMKESMAS

06/11-09/11 IV CAT-SURFLO 20 1 11,136 11,136

FAM D SPUIT 5 CC TERUMO 1 1,848 1,848

CROMIC 3/0 1 58,212 58,212

7-Nov BEDAH AP 28082 SPUIT 5 CC TERUMO 2 1,848 3,696




GLUKOSE 5 %-WD 1 4,247 4,247








PROANES INJ 1 79,200 79,200










DARYANTUL 1 15,394 15,394

PENROSE DRAIN 5/8 1 78,000 78,000








09/11 BEDAH ANDY 24,735 AMOKSISILIN 500 TABLET BERNO 15 446 6,690

ANIOS ADP 55,000

IODINE 100 20,000


KASA 4 44,000

CROMIC 2/0 1/2 4,900

FORMALIN 20 1,000

ALKOHOL 100 5,000

ARP 1 25,500


LINAPEN 1 17,000

O2 1 4,400

N2O 0.25 31,500


BHP 66,600

1,315,7643 23/10 BEDAH HIDAYATI AP 6678 INFUS SET 0I-34 1 13,860 13,860 1,163,791


23/10-26/10 RINGER LAKTAT-WB 1 5,220 5,220

Susp FAM S

24/10 BEDAH ANDY 23796 NYLON 3/0 D5 24 SHARPOINT 1 56,100 56,100






PROANES INJ 1 79,200 79,200









PENROSE DRAIN 5/8 1 78,000 78,000

DARYANTUL 1 15,394 15,394

INFUS SET 0I-34 1 13,860 13,860

IV CAT-SURFLO 18 1 11,136 11,136




.24/10 BEDAH ANDY 6716 KETOROLAC INJ 30-BRN 2 11,220 22,440





GLUKOSE 5 %-WD 1 4,247 4,247







ANIOS ADP 55,000

IODINE 100 20,000



KASA SILVER 2 9,800

CROMIC 2/0 1/2 4,900

ALKOHOL 50 2,500

FORMALIN 10 500

ARP 1 25,500

JARUM 1 15,000

LINAPEN 1 17,000

O2 0.5 4,400

N2O 0.25 31,500


BHP 66,600

1,163,7914 6-Nov BEDAH MARYANI ANDY 28045 NYLON 4/0 D5 18 SHARPOINT 1 56,100 56,100 1,153,492


06/11-09/11 IV CAT-SURFLO 20 1 11,136 11,136

FAM S BILATERAL SPUIT 5 CC TERUMO 1 1,848 1,848








GLUKOSE 5 %-WD 1 4,247 4,247






PROANES INJ 1 79,200 79,200










DARYANTUL 1 15,394 15,394

PENROSE DRAIN 5/8 1 78,000 78,000









ANIOS ADP 55,000

IODINE 100 20,000


KASA 4 44,000

CROMIC 2/0 1/2 4,900

FORMALIN 20 1,000

ALKOHOL 50 2,500

ARP 1 25,500


LINAPEN 1 17,000

O2 0.5 4,400

N2O 0.25 31,500


BHP 66,600

1,153,4925 .23/11 BEDAH SANTI ANDY 50088 RINGER LAKTAT-WB 1 5,220 5,220 1,213,735


23/11-28/11 IV CAT-SURFLO 20 1 11,136 11,136

Fam D SPUIT 5 CC TERUMO 1 1,848 1,848

24-Nov BEDAH ANDY 51000 IV CAT-SURFLO 20 1 11,136 11,136

1 IV CAT-SURFLO 22 1 11,136 11,136

24-Nov BEDAH ANDY 28613 NYLON 4/0 D5 18 SHARPOINT 1 56,100 56,100

24-Nov OK ANDY 28633 PISAU BEDAH 10 -AESCULAP 1 2,072 2,072





PROANES INJ 1 79,200 79,200









IV CAT-SURFLO 20 1 11,136 11,136

EPINEPRIN INJ-ETHICA 2 2,901 5,802





GLUKOSE 5 %-WD 1 4,247 4,247









BURNAZIN CR 35 G 1 40,953 40,953






27-Nov BEDAH MARUHUM 50708 RINGER LAKTAT-WB 1 5,220 5,220

1 SPUIT 5 CC TERUMO 1 1,848 1,848

SPUIT 20 CC WITHOUT N TER 1 5,742 5,742

28-Nov BEDAH MARUHUM 25174 AMOKSISILIN 500 TABLET BERNO 15 446 6,690

ANIOS ADP 55,000

IODINE 100 20,000


KASA 4 44,000

CROMIC 2/0 1/2 4,900

ALKOHOL 50 2,500

FORMALIN 20 1,000

ARP 1 25,500


LINAPEN 1 17,000

O2 0.5 4,400

N2O 0.25 31,500


BHP 135,600

1,213,7356 4-Dec BEDAH SITI NURITHA ANDY ANIOS ADP 55,000 499,000

MD.047259 SKM04/12-06/12 IODINE 100 20,000

FAM d multiple WASH SCRUB 100 25,000


SILK 2/0 1/2 2,100

FORMALIN 20 1,000

ARP 1 25,500

ALKOHOL 100 5,000


LINAPEN 1 17,000

O2 0.5 4,400

N2O 0.25 31,500


BHP 51,000

ANDI 22368 KALNEX 500 28,000

499,0007 .30/11 BEDAH DEWI ANDY 50548 INFUS SET 0I-34 1 13,860 13,860 1,278,998

2 MD 285346 NYLON 4/0 D5 18 SHARPOINT 1 56,100 56,100 JAMKESMAS

30/11-03/12 RINGER LAKTAT-WB 1 5,220 5,220

FAM S IV CAT-SURFLO 22 1 11,136 11,136







PROANES INJ 1 79,200 79,200









PENROSE DRAIN 5/8 1 78,000 78,000






1/12 BEDAH AP 50584 CEFTRIAXON INJ 1 G-HXP 1 7,983 7,983





GLUKOSE 5 %-WD 1 4,247 4,247







ANIOS ADP 55,000

IODINE 75 15,000


KA SA SEDANG 2 22,000

CROMIC 2/0 1 9,800

KASA SILVER 2 9,800

FORMALIN 10 500

ARP 1 25,500

ALKOHOL 50 2,500


LINAPEN 1 17,000

O2 0.5 4,400

N2O 0.25 31,500


BHP 66,600

1,278,998 TOTAL 7,967,618 Rata-rata 1,138,231

Tabel Biaya Pasien LimpomatosisOktober-Desember 2012 RSUD Kota Bandung


1 3-Oct BEDAH HEDI MN 6303 IV CAT-SURFLO 20 1 11,136 11,136 1,299,540


03/10-05/10 RINGER LAKTAT-WB 1 5,220 5,220

Lipomatosis SPUIT 5 CC TERUMO 1 1,742 1,742

BLUE NYLON 3/0 CUTING/BLUE MONOLON 2 53,460 106,920







PROANES INJ 1 75,240 75,240













CROMIC 2/0 SHARPOINT 2 61,710 123,420


4-Oct BEDAH MN 6410 RINGER LAKTAT-WB 3 5,220 15,660

2 CEFTRIAXON INJ 1 G BERNO 2 6,970 13,940



GLUKOSE 5 %-WD 2 4,247 8,494




ANIOS ADP 55,000

IODINE 150 30,000



CROMIC 2/0 1 29,400

SILK 2/0 1 4,200

ALKOHOL 100 5,000

ARP 1 25,500


LINAPEN 1 17,000

O2 0.5 4,400

N2O 0.25 31,500


BHP 49,800

1,299,540

2 18-Dec BEDAH NANA ANDY 27984 INFUS SET 0I-34 1 13,860 13,860 2,240,2652 MD.020461 IV CAT-SURFLO 20 1 11,136 11,136 JAMKESMAS

18/12-21/12 RINGER LAKTAT-WB 1 5,220 5,220

Lipomatosis SPUIT 5 CC TERUMO 1 1,848 1,848


CROMIC 4/0 JABAR MEDIKA 1 67,320 67,320

18-Dec BEDAH MN 27994 CEFOTAXIM INJ 1 G-HXP 1 4,895 4,895



19-Dec OK YUDHIE 51186 PISAU BEDAH 10 -AESCULAP 1 2,072 2,072

1 SARUNG TANGAN GAMEX 7 .5 4 9,900 39,600



PROANES INJ 1 79,200 79,200









PEMBALUT ELASTIS TENSOCREPE 10 CM4" 1 68,883 68,883




19-Dec BEDAH SIMAMORA 27839 CEFOTAXIM INJ 1 G-HXP 2 4,895 9,790



GLUKOSE 5 %-WD 2 4,247 8,494





1 SPUIT 5 CC TERUMO 2 1,848 3,696

21-Dec ANDY 52136 AMOKSISILIN 500 TABLET BERNO 15 446 6,690

ANIOS ADP 55,000

IODINE 150 30,000



ALKOHOL 100 5,000

FORMALIN 40 2,000

ARP 1 25,500

CROMIC 2/0 1/2 4,900

SILK 2/0 1 4,200


LINAPEN 1 17,000

O2 0.5 4,400

N2O 0.25 31,500


BHP 89,700

28-Dec BEDAH ANDY 29617 RINGER LAKTAT-WB 1

IV CAT-SURFLO 20 1

INFUS SET DWS- TERUMO 1 30,000

YUDHIE 52750 PISAU BEDAH 10 -AESCULAP 1

CROMIC 2/0 JABAR MEDIKA 1

TOPI OPERASI 2

MASKER TIE ON SUREPLUS 2

SARUNG TANGAN T GLOVE 6.5 1

NYLON 3/0 D5 24 SHARPOINT 1

PROANES INJ 1

KALTROFEN SUPP 1

TERANOL INJ 30 MG 5

SPUIT 10 CC TERUMO 1

SPUIT 3 CC TERUMO 1

SPUIT 5 CC TERUMO 1

ONDANE INJ 8MG 1

RINGER LAKTAT-WB 1

SARUNG TANGAN T GLOVE 6.5 2

SURGIVIT STILE 2/0 TAPER 1

TICRON 1 3113 71 1

KALTROFEN SUPP 1

DEXAMETASON INJ.-LUCAS 2 741,000

MARHUM 29701 CEFOTAXIM INJ 1 G-BERNO 2

TERANOL INJ 30 MG 2

RINGER LAKTAT-WB 3

GLUKOSE 5 %-WD 2

SPUIT 5 CC TERUMO 2

SPUIT 3 CC TERUMO 2

SPUIT 1 CC INS TERUMO 1 108,000

SIMAMORA 52572 CEFOTAXIM INJ 1 G-BERNO 4

TERANOL INJ 30 MG 2

SPUIT 3 CC TERUMO 4

SPUIT 5 CC TERUMO 4 95,000

2,240,2653 6-Nov BEDAH MIMIN ANDY 28045 NYLON 3/0 D5 24 SHARPOINT 1 56,100 56,100 1,267,575

2 MD 144759 INFUS SET 0I-34 1 13,860 13,860 SKM06/11-10/11 IV CAT-SURFLO 20 1 11,136 11,136

Limphoma Acute SPUIT 5 CC TERUMO 1 1,848 1,848

7-Nov BEDAH ANDY 28100 SPUIT 5 CC TERUMO 2 1,848 3,696




GLUKOSE 5 %-WD 2 4,247 8,494








PROANES INJ 1 79,200 79,200










PENROSE DRAIN 5/8 1 78,000 78,000






GLUKOSE 5 %-WD 1 4,247 4,247








10-Nov BEDAH SIMMAMOR 24614 AMOKSISILIN 500 TABLET BERNO 15 446 6,690

1 METRONIDAZOL 500 BERNO 15 140 2,100

ANIOS ADP 55,000

IODINE 100 20,000



CROMIC 2/0 1/2 4,900

FORMALIN 20 1,000

ARP 1 25,500

ALKOHOL 50 2,500


LINAPEN 1 17,000

O2 0.5 4,400

N2O 0.25 31,500


BHP 115,000

9-NOV BEDAH ANDY 25458 TRAMADOL TAB 50 berno 10

NUTRIFLAM KAP 6 41,000

1,267,5754 14-Nov BEDAH ALIT ANDI ANIOS ADP 55,000 505,900

MD.151753 SKM14/11-16/11 IODINE 150 30,000

Limphoma Kista Ateron WASH SCRUB 100 25,000


CROMIC 2/0 2 19,600


FORMALIN 10 500

SILK 2/0 1 4,200

ARP 1 25,500

ALKOHOL 100 5,000

JARUM 1 15,000

LINAPEN 1 17,000

O2 0.5 4,400

N2O 0.25 31,500


BHP 51,000

505,9005 1-Nov MATA DEDE AMARANITH 7184 SARUNG TANGAN TERUGLOVE 6.5 8 9,009 72,072 1,422,252

MD.022759 TOPI OPERASI 2 792 1,584 JAMKESMAS

01/11-01/11 MASKER TIE ON SUREPLUS 2 792 1,584

Limpomatosis SPUIT 5 CC TERUMO 1 1,848 1,848


LIDOKAIN INJ 2% LUCAS 1 1,254 1,254

CHLORAMFENICOL. SM-KF 1 1,876 1,876

NYLON 10/0 1 198,000 198,000

VYCRIL 8/0-ETHICON 1 198,000 198,000


GENTAMYCIN INJ.-INF 1 4,032 4,032


INFUS SET 0I-34 1 13,860 13,860

NEDDLE 27 G TER 1 326 326


BHP OK 63,900

BHP MATA 840,000

30-Oct BEDAH ANIS ANDY 7082 IV CAT-SURFLO 20 1 11,136 11,136

1,422,2526 7-Nov BEDAH ELAH SIMAMORA 28103 INFUS SET 0I-34 1 13,860 13,860 995,094

3 MD 291859 IV CAT-SURFLO 20 1 11,136 11,136 JAMKESMAS

07/11-09/11 RINGER LAKTAT-WB 1 5,220 5,220

LIPOMA SPUIT 5 CC TERUMO 1 1,848 1,848






PROANES INJ 1 79,200 79,200










PENROSE DRAIN 5/8 1 78,000 78,000





GLUKOSE 5 %-WD 2 4,247 8,494




7-Nov BEDAH ANDY 24844 NYLON 2/0 SHARPOINT 1 61,710 61,710


ANIOS ADP 55,000

IODINE 100 20,000


KASA 3 33,000

SILK 2/0 1/2 2,100

ALKOHOL 50 2,500

ARP 1 25,500


LINAPEN 1 17,000

O2 1 4,400

N2O 0 31,500


BHP 51,000

995,094

7 2 Eman RINGER LAKTAT-WB 1 5,220 5,220 1,272,673

MD 625059 IV CAT-SURFLO 20 1 11,136 11,136 JAMKESMAS

04/12-06/12 SPUIT 5 CC TERUMO 1 1,848 1,848

Sub Limphoma NYLON 3/0 D5 24 SHARPOINT 1 56,100 56,100

5-Dec BEDAH ANDY 25516 CEFTRIAXON INJ 1 G-HXP 2 7,983 15,966



GLUKOSE 5 %-WD 1 4,247 4,247










PROANES INJ 1 79,200 79,200













6-Dec BEDAH ANDY 25583 AMOKSISILIN 500 TABLET BERNO 15 446 6,690

ANIOS ADP 55,000

IODINE 100 20,000



CROMIC 2/0 1 9,800

FORMALIN 20 1,000

ARP 1 25,500

ALKOHOL 100 5,000


LINAPEN 1 17,000

O2 0.5 4,400

N2O 0.25 31,500

SEVOFLURENT 35 455,000

BHP 49,800

1,272,673TOTAL 9,003,299Rata-rata 1,286,185

Tabel Biaya Pasien Tumor Mamae DexOktober-Desember 2012 RSUD Kota Bandung


1 24-Oct BEDAH ENTIN MN 6731 CROMIC 3/0 HR26 SHARPOINT 1 61,710 61,710 1,561,331

3 MD.930459 NYLON 3/0 D5 24 SHARPOINT 1 56,100 56,100 JAMKESMAS

24/10-27/10 RINGER LAKTAT-WB 1 5,220 5,220

Tumor Mammae IV CAT-SURFLO 20 1 11,136 11,136

INFUS SET 0I-34 1 13,860 13,860

25-Oct BEDAH ANDY 23663 CROMIC 3/0 HR26 SHARPOINT 1 61,710 61,710

1 BLUE NYLON 3/0 CUTING/BLUE MONOLON 1 56,100 56,100

.25/10 BEDAH MN 6798 CEFTRIAXON INJ 1 G-HXP 1 7,983 7,983

3 CIPROFLOXACIN TAB 500 -INF 6 636 3,816


GLUKOSE 5 %-WD 2 4,247 8,494

TERANOL INJ 30 MG 2 27,456 54,912










PROANES INJ 1 79,200 79,200









PENROSE DRAIN 5/8 1 78,000 78,000





26-Oct BEDAH ANDY 23566 CEFTRIAXON INJ 1 G-HXP 1 7,983 7,983

1 CIPROFLOXACIN infus-DX 2 30,024 60,048







ANIOS ADP 55,000

IODINE 100 20,000



SILK 2/0 1 4,200

FORMALIN 10 500

ARP 1 25,500

JARUM 1 15,000

ALKOHOL 100 5,000

LINAPEN 1 17,000

O2 0.5 4,400

N2O 0.25 31,500


BHP 86,100

1,561,3312 .9/10 BEDAH LINA ANDY 20236 RINGER LAKTAT-WB 1 5,220 5,220 1,238,370

3 MD 220659 IV CAT-SURFLO 20 1 11,136 11,136 SKM09/10-13/10 INFUS SET 0I-34 1 13,860 13,860

Tumor Mammae NYLON 3/0 D5 24 SHARPOINT 1 56,100 56,100


2 KETOROLAC 30MG INJ DEXA 2 8,853 17,706





GLUKOSE 5 %-WD 1 4,247 4,247






PROANES INJ 1 79,200 79,200









PENROSE DRAIN 5/8 1 78,000 78,000















ANIOS ADP 55,000

IODINE 100 20,000



CROMIC 2/0 1 9,800

ARP 1 25,500

FORMALIN 10 500

ALKOHOL 100 5,000

JARUM 1 15,000

LINAPEN 1 17,000

O2 0.5 4,400

N2O 0.25 31,500


BHP 104,100

1,283,3703 2-Nov BEDAH PIPIT SIMAMORA 7321 INFUS SET 0I-34 1 13,860 13,860 1,328,228

2 MD 520959 IV CAT-SURFLO 20 1 11,136 11,136 JAMKESMAS

02/11-08/11 RINGER LAKTAT-WB 1 5,220 5,220

Tumor Mammae

2-Nov BEDAH SIMAMORA 7334 NYLON 4/0 D5 18 SHARPOINT 1 56,100 56,100






PROANES INJ 1 79,200 79,200









PENROSE DRAIN 5/8 1 78,000 78,000



3-Nov BEDAH MN 7381 CEFOTAXIM INJ 1 G-HXP 2 4,895 9,790



GLUKOSE 5 %-WD 2 4,247 8,494









6-Nov BEDAH SIMAMORA 28020 INFUS SET 0I-34 1 13,860 13,860

2 IV CAT-SURFLO 20 1 11,136 11,136









8-Nov BEDAH ANDY 24854 AMOKSISILIN 500 TABLET BERNO 15 446 6,690

ANIOS ADP 55,000

IODINE 100 20,000



ALKOHOL 50 2,500

SILK 2/0 1/2 2,100

ARP 1 25,500

FORMALIN 30 1,500


LINAPEN 1 17,000

O2 0.5 4,400

N2O 0.25 31,500


BHP 207,600

1,328,2284 6-Nov BEDAH HENI ANDY 28,040 NYLON 4/0 D5 18 SHARPOINT 1 56,100 56,100 1,084,047


06/11-09/11 IV CAT-SURFLO 20 1 11,136 11,136

Tumor Mammae SPUIT 5 CC TERUMO 1 1,848 1,848

07/11 BEDAH ANDY 2,408 CEFTRIAXON INJ 1 G-HXP 1 7,983 7,983






GLUKOSE 5 %-WD 1 4,247 4,247

07/11 OK YUDHIE 24,963 PISAU BEDAH 10 -AESCULAP 1 2,072 2,072





PROANES INJ 1 79,200 79,200










DARYANTUL 1 15,394 15,394

PENROSE DRAIN 5/8 1 78,000 78,000




ANIOS ADP 55,000

IODINE 100 20,000


KASA 3 33,000

CROMIC 2/0 1 4,900

FORMALIN 10 500

ARP 1 25,500


LINAPEN 1 17,000

O2 1 4,400

N2O 0 31,500


BHP 63,000

1,084,0475 14-Dec BEDAH FUJI ANDY ANIOS ADP 55,000 568,500

MD.790161 JAMKESMAS

14/12-19/12 IODINE 100 20,000

Tumor Mammae WASH SCRUB 100 25,000


SILK 2/0 1 4,200

LINAPEN 1 17,000

ARP 1 25,500

FORMALIN 20 1,000

JARUM 1 15,000

ALKOHOL 100 5,000

O2 0.5 4,400

N2O 0.25 31,500


BHP 146,400

568,500TOTAL 5,780,476Rata-rata 1,156,095

Tabel Biaya Pasien AppendicitisOktober-Desember 2012 RSUD Kota Bandung


1 3-Oct BEDAH SRI I MN 6305 IV CAT-SURFLO 20 1 11,136 11,136 2,024,381

3 MD 924658 INFUS SET 0I-34 1 13,860 13,860 SKM

03/10-07/10 RINGER LAKTAT-WB 1 5,220 5,220

Apenddicitis Kronik SPUIT 5 CC TERUMO 1 1,742 1,742

optime 2/0 18s30j 1 95,040 95,040


4-Oct OK YUDHIE 22719 STOMAG TUIBE 16 TERUMO 125 CM 1 15,444 15,444

1 URINE BAG COSMOMED 1 5,940 5,940

PROANES INJ 1 75,240 75,240








ETT 6,5 RUSCH 1 77,933 77,933





PISAU BEDAH 10 -AESCULAP 1 2,701 2,701






SILK 2/0 SHARPOINT 3 50,490 151,470

NACL 0.9% 500 ML-WB 2 4,834 9,668


SURGIVIT STILE 2/0 TAPER 1 95,040 95,040

POLYSIN IC 14 1 89,760 89,760


4-Oct BEDAH MN 6411 RINGER LAKTAT-WB 2 5,220 10,440

2 CEFTRIAXON INJ 1 G BERNO 2 6,970 13,940



GLUKOSE 5 %-WD 2 4,247 8,494












6-Oct BEDAH ANDY 6471 IV CAT-SURFLO 20 1 11,136 11,136

2 INFUS SET 0I-34 1 13,860 13,860


ANIOS ADP 55,000

IODINE 150 30,000


KASA 4 44,000


CROMIC 2/0 2 19,600

ALKOHOL 100 5,000

SILK 2/0 2 8,400

ARP 1 25,500

FORMALIN 10 500


LINAPEN 1 17,000

O2 0.5 4,400

N2O 0.25 31,500


BHP 110,700

2,024,381

2 7-Oct BEDAH DEDE ANDY 20181 RANITIDIN INJ BERNO 1 2,146 2,146 1,951,949

MD.092459 SPUIT 3 CC TERUMO 1 1,371 1,371 SKM

07/10-11/10 SPUIT 5 CC TERUMO 1 1,742 1,742

Appendicitis Akut PARASETAMOL MARIN 6 120 720


1 RINGER LAKTAT-WB 4 5,220 20,880

GLUKOSE 5 %-WD 2 4,247 8,494






SURGIVIT STILE 3/0 AILEE 1 81,972 81,972

SURGIVIT STILE 1 CUTTING/SURGION 1 97,416 97,416

STOMAG TUIBE 18 TERUMO 125 CM 1 15,444 15,444



SILK 2/0 TUNAS 1 48,708 48,708

DARYANTUL 1 15,394 15,394

NACL 0.9% 500 ML-WB 4 4,834 19,336



CURASPON 3 50,160 150,480

PROANES INJ 1 75,240 75,240








ETT 6,5 RUSCH 1 77,933 77,933





WIDAHES 130 ASKIN 1 61,800 61,800


MILOZ INJ 15 ASKIN 1 14,310 14,310


1 DIAZOLE INF ASKIN 3 9,600 28,800


GLUKOSE 5 %-WD 1 4,247 4,247
















ANTASID TAB.-KF 15 110 1,650

ANIOS ADP 55,000

IODINE 150 30,000


KASA X RAY 4 53,600

ARP 1 25,500

FORMALIN 10 500

ALKOHOL 100 5,000

JARUM 1 15,000

LINAPEN 1 17,000

O2 0.5 4,400

N2O 0.25 31,500


BHP 108,900

1,951,949

3 11-Nov IGD YONI HENNY 24574 INFUS SET 0I-34 1 13,860 13,860 1,999,021


11/11-15/11 IV CAT-SURFLO 20 1 11,136 11,136

Appendic Aeut RATAN INJ ASKIN 1 1,200 1,200


11-Nov IGD HENNY 24598 CEFOTAXIM INJ 1 G-HXP 1 4,895 4,895



DIAZOLE INF ASKIN 1 9,600 9,600



11-Nov BEDAH ANDY 28345 CEFTRIAXON INJ 1 G BERNO 1 6,970 6,970









SURGIVIT STILE 3/0 AILEE/SURGION 1 81,972 81,972

SURGIVIT STILE 1 CUTTING/SURGION 1 97,416 97,416

STOMAG TUIBE 18 TERUMO 125 CM 1 16,632 16,632



SILK 2/0 TUNAS 1 48,708 48,708

DARYANTUL 1 15,394 15,394

NACL 0.9% 500 ML-WB 4 5,587 22,348



CURASPON 80X50X10 3 41,844 125,532

PROANES INJ 1 79,200 79,200






ETT 6,5 RUSCH 1 53,460 53,460


WIDAHES 130 ASKIN 1 61,800 61,800










GLUKOSE 5 %-WD 1 4,247 4,247


.13/11 BEDAH ANDY 7476 SPUIT 5 CC TERUMO 3 1,848 5,544

1 CEFOTAXIM INJ 1 G-HXP 2 4,895 9,790




3 INFUS SET 0I-34 1 13,860 13,860

13-Nov BEDAH ANDY 28500 NASAL OKSIGEN DWS PASCHO 1 21,600 21,600

14-Nov BEDAH SIMMAMOR 24121 CEFOTAXIM INJ 1 G-HXP 2 4,895 9,790





15-Nov BEDAH SIMMAMOR 24509 AMOKSISILIN 500 TABLET BERNO 15 446 6,690

1 RANITIDIN TAB 150-BERNO 10 216 2,160

ANIOS ADP 55,000

IODINE 150 30,000



X RAY 2 26,800

CROMIC 2/0 1 9,800

ALKOHOL 100 5,000

ARP 1 25,500

FORMALIN 10 500

JARUM 1 15,000

LINAPEN 1 17,000

O2 0.5 4,400

N2O 0.25 31,500


BHP 141,000

1,999,021

4 15-Nov BEDAH YUNI ANDY 24000 INFUS SET 0I-34 1 13,860 13,860 1,825,305


14/11-18/11 SPUIT 5 CC TERUMO 1 1,848 1,848

Appendicitis


15-Nov OK YUDHIE 24178 optime 2/0 18s30j 1 95,040 95,040

1 ADVANTIME 4/0 1 118,800 118,800







PROANES INJ 1 79,200 79,200










IV CAT-SURFLO 18 1 11,136 11,136

INFUS SET 0I-34 1 13,860 13,860





15-Nov BEDAH MN 29112 CEFTRIAXON INJ 1 G-HXP 2 7,983 15,966



GLUKOSE 5 %-WD 2 4,247 8,494















ANIOS ADP 55,000

IODINE 100 20,000



KASA X RAY 1 13,400

CROMIC 2/0 2 19,600

SILK 2/0 1 4,200

ARP 1 25,500

FORMALIN 20 1,000

ALKOHOL 100 5,000

JARUM 1 15,000

LINAPEN 1 17,000

O2 0.5 4,400

N2O 0.25 31,500


BHP 107,700

1,825,3085 21-Nov IGD NENA HENY 25946 INFUS SET 0I-34 1 13,860 13,860 1,017,723

MD.718059 RINGER LAKTAT-WB 1 5,220 5,220 JAMKESMAS

21/11-29/11 IV CAT-SURFLO 20 1 11,136 11,136

Appendicitis Acut KETOROLAC INJ 30-BRN 1 8,911 8,911













22-Nov BEDAH ANDY 28963 KETOROLAC INJ 30-BRN 2 8,911 17,822










KETOROLAC 30MG INJ DEXA 3 8,853 26,559





INFUS SET 0I-34 1 13,860 13,860

IV CAT-SURFLO 20 1 11,136 11,136




25-Nov BEDAH ANDY 28725 RINGER LAKTAT-WB 2 5,220 10,440

1 CEFOTAXIM INJ 1 G-HXP 3 4,895 14,685













IV CAT-SURFLO 20 2 11,136 22,272

INFUS SET 0I-34 2 13,860 27,720








BHP 210,000

1,017,723TOTAL 8,818,379Rata-rata 1,763,676

Tabel Biaya Pasien Gangguan GanglionOktober-Desember 2012 RSUD Kota Bandung


1 26/10 BEDAH YATI ANDY 6,846 INFUS SET 0I-34 1 13,860 13,860 1,200,0483 MD 633559 RINGER LAKTAT-WB 1 5,220 5,220 JAMKESMAS

26/10-28/10 IV CAT-SURFLO 20 1 11,136 11,136

Ganglion a/r Wrist SPUIT 5 CC TERUMO 1 1,848 1,848

BLUE NYLON 4/0 CUTING/BLUE MONOLON 4/0 1 57,024 57,024

27/10 OK YUDHIE 23,443 PISAU BEDAH 10 -AESCULAP 1 2,072 2,072






PROANES INJ 1 79,200 79,200









SURGICRIL 3/0 1 58,960 58,960

PEMBALUT ELASTIS TENSOCREPE 10 CM4" 1 68,883 68,883



27/10 BEDAH ANDY 23,477 CEFTRIAXON INJ 1 G-HXP 1 7,983 7,983






GLUKOSE 5 %-WD 1 4,247 4,247

.28/10 BEDAH ANDY 6,948 AMOKSISILIN 500 INF 10 444 4,440

2 AS. MEFENAMAT 500-KF 10 153 1,530

ANIOS ADP 55,000

IODINE 100 20,000


KASA 3 33,000

ALKOHOL 50 2,500

ARP 1 25,500

CROMIC 2/0 1/2 4,600


LINAPEN 1 17,000

O2 0.5 4,400

N2O 0.25 31,500


BHP 47,400

1,200,0482 7-Nov BEDAH ADE MAKMUR ANDY BHP 159,600 159,600

MD.537552 SKM07/11-15/11

Ganglion

159,6003 4-Dec BEDAH BUDIMAN ANDY ANIOS ADP 55,000 710,750

MD.666859 SKM04/12-06/12 IODINE 75 15,000

Ganglion Dorsum WASH SCRUB 75 18,750


FORMALIN 10 500

ARP 1 25,500

ALKOHOL 50 2,500


LINAPEN 1 17,000

O2 0.5 4,400

N2O 0.25 31,500


BHP 51,000

710,7504 4-Dec BEDAH LILIS ANDY ANIOS ADP 55,000 464,700

MD.458459 SKM04/12-06/12 IODINE 100 20,000

Ganglion corist joint S WASH SCRUB 100 25,000


FORMALIN 10 500

ARP 1 25,500

ALKOHOL 50 2,500


LINAPEN 1 17,000

O2 0.5 4,400

N2O 0.25 31,500


BHP 49,800

464,7005 7-Dec BEDAH ADE ANDY ANIOS ADP 55,000 463,550

MD.208259 SKM07/12-09/12 IODINE 75 15,000

Ganglion a/n chorist joint D WASH SCRUB 75 18,750


ARP 1 25,500

CROMIC 2/0 1/2 4,900

ALKOHOL 50 2,500

BEDLINER 1 31,200

FORMALIN 10 500

LINAPEN 1 17,000

O2 0.5 4,400

N2O 0.25 31,500


BHP 49,800

463,550TOTAL 2,998,648Rata-rata 599,729

Tabel Biaya Pasien FibromaOktober-Desember 2012 RSUD Kota Bandung


1 5-Oct BEDAH UJANG UMAR AP 6362 IV CAT-SURFLO 20 1 11,136 11,136 1,341,8833 MD.200059 INFUS SET 0I-34 1 13,860 13,860 SKM

05/10-10/10 RINGER LAKTAT-WB 1 5,220 5,220

Sus Fibroma Abses SPUIT 5 CC TERUMO 1 1,742 1,742








CEFOTAXIM INJ 1 G-BERNO 1 4,801 4,801


PROANES INJ 1 75,240 75,240


ONDANSENTRON INJ 4 MG BERNO askes 1 4,740 4,740







MILOZ INJ 15 ASKIN 1 14,310 14,310

PEMBALUT ELASTIS TENSOCREPE 7,5 CM3" 1 53,040 53,040




GLUKOSE 5 %-WD 1 4,247 4,247





1 SPUIT 3 CC TERUMO 2 1,371 2,742









ANIOS ADP 55,000

IODINE 100 20,000



ARP 1 25,500

CROMIC 2/0 1 9,800

ALKOHOL 100 5,000

JARUM 1 15,000

LINAPEN 1 17,000

O2 0.5 4,400

N2O 0.25 31,500


BHP 133,200

1,341,8832 19-Oct BEDAH WIDANINGSIH ANDY 20813 NYLON 4/0 D5 18 SHARPOINT 1 56,100 56,100 1,363,608

2 MD 022459 INFUS SET 0I-34 1 13,860 13,860 SKM

19/10-24/10 IV CAT-SURFLO 20 1 11,136 11,136

Fibroma SPUIT 5 CC TERUMO 1 1,848 1,848







PROANES INJ 1 79,200 79,200













20-Oct OK AP 20864 CEFTRIAXON INJ 1 G BERNO 2 6,970 13,940



GLUKOSE 5 %-WD 1 4,247 4,247















ANIOS ADP 55,000

IODINE 100 20,000



CROMIC 2/0 1 9,800

ARP 1 25,500

JARUM 1 15,000

ALKOHOL 100 5,000

LINAPEN 1 17,000

O2 0.4 4,400

N2O 0.25 31,500


BHP 162,300

1,363,608

3 2 Anis INFUS SET 0I-34 1 13,860 13,860 1,078,945MD 163959 RINGER LAKTAT-WB 1 5,220 5,220 JAMKESMAS30/10-02/11 SPUIT 5 CC TERUMO 1 1,848 1,848

Fibroma NYLON 4/0 D5 18 SHARPOINT 1 56,100 56,100







PROANES INJ 1 79,200 79,200










AS. TRANEKSAMAT INJ 500MG-BRN 1 6,237 6,237


MILOZ INJ 15 ASKIN 1 14,310 14,310

31-Oct BEDAH ANDY 7203 CEFTRIAXON INJ 1 G-HXP 1 7,983 7,983






GLUKOSE 5 %-WD 1 4,247 4,247






2-Nov BEDAH ANDY 23106 AMOKSISILIN 500 KF 15 444 6,660

ANIOS ADP 55,000

IODINE 100 20,000



ALKOHOL 50 2,500

FORMALIN 10 500

ARP 1 25,500

CROMIC 2/0 1/2 4,900


LINAPEN 1 17,000

O2 0.5 4,400

N2O 0.25 31,500


BHP 66,600

1,078,9454 31-Oct BEDAH M.NURALI MN 7215 IV CAT-SURFLO 20 1 11,136 11,136 1,055,685

3 MD.709858 RINGER LAKTAT-WB 1 5,220 5,220 JAMKESMAS31/10-04/11 INFUS SET 0I-34 1 13,860 13,860

Fibroma a/n Dectoid SPUIT 5 CC TERUMO 1 1,848 1,848

31-Oct BEDAH MN 7216 NYLON 3/0 D5 24 SHARPOINT 1 56,100 56,100






PROANES INJ 1 79,200 79,200













GLUKOSE 5 %-WD 2 4,247 8,494








3-Nov BEDAH ANDI 23176 CEFOTAXIM INJ 1 G-HXP 2 4,895 9,790



4-Nov BEDAH ANDY 23052 AMOKSISILIN 500 INF 15 444 6,660

ANIOS ADP 55,000

IODINE 100 20,000


KASA 3 33,000

ALKOHOL 50 2,500

FORMALIN 10 500

SILK 2/0 1/2 2,100

ARP 1 25,500


LINAPEN 1 17,000

O2 0.5 4,400

N2O 0.25 31,500


BHP 111,300

1,055,685TOTAL 4,840,121Rata-rata 1,210,030

Tabel Biaya Pasien AbsesOktober-Desember 2012 RSUD Kota Bandung


1 11-Nov BEDAH YANTI AYU 24660 AMPISILIN INJ BERNO 4 5,335 21,340 1,399,340

1 MD.035759 CEFOTAXIM INJ 1 G-HXP 3 4,895 14,685 JAMKESMAS

11/11-17/11 DIAZOLE INF ASKIN 2 9,600 19,200

Abses a/n post SPUIT 5 CC TERUMO 7 1,848 12,936

12-Nov BEDAH ANDY 24055 AMPISILIN INJ BERNO 5 5,335 26,675





SPUIT 10 CC TERUMO 6 2,027 12,162











14-Nov BEDAH SIMAMORA 28458 BLUE NYLON 4/0 CUTING/BLUE MONOLON 4/0 1 57,024 57,024

15-Nov BEDAH ANDY 24542 SPUIT 3 CC TERUMO 2 1,122 2,244

1 SPUIT 5 CC TERUMO 5 1,848 9,240

AMPICILIN INJ BERNO 3 4,158 12,474





GLUKOSE 5 %-WD 1 4,247 4,247

15-Nov OK YUDHIE 24199 PISAU BEDAH 15-AESCULAP 1 2,700 2,700





PENROSE DRAIN 5/8 1 78,000 78,000



INFUS SET 0I-34 1 13,860 13,860

IV CAT-SURFLO 18 1 11,136 11,136












17-Nov BEDAH ANDY 29247 AMOKSISILIN 250- INF 15 286 4,290

2 AS. MEFENAMAT 500-KF 8 153 1,224

ANTASID TAB.-KF 15 162 2,430

METRONIDAZOL TAB 250-INF 15 102 1,530

ANIOS ADP 55,000

IODINE 75 15,000



CROMIC 2/0 1/2 4,900

SILK 2/0 1/2 2,100

FORMALIN 10 500

ARP 1 25,500

ALKOHOL 50 2,500

JARUM 1 15,000

LINAPEN 1 17,000

O2 0.5 4,400

N2O 0.25 31,500


BHP 162,600

1,399,3402 02/11 BEDAH RAVA ANDY 23300 CEFOTAXIM INJ 1 G-HXP 1 4,895 4,895 571,629

1 MD.855259 DIAZOLE INF ASKIN 1 9,600 9,600 SKM

01/11-08/11 AMOKSISILIN SYR 125-INF 1 4,081 4,081

Abses a/n post NACL 0.9% 500 ML-WB 1 5,587 5,587



03/11 BEDAH ANDY 23182 CEFOTAXIM INJ 1 G-HXP 1 4,895 4,895




03/11 BEDAH MN 7380 IV CAT-SURFLO 24 2 10,560 21,120

3 INFUS SPALK 4 X 15 1 8,527 8,527

INFUS SET PAED- 0I-34 OTSUKA 1 9,900 9,900

04/11 BEDAH ANDY 23070 CEFOTAXIM INJ 1 G-HXP 1 4,895 4,895





04/11 BEDAH ANDY 29020 INFUS SET PAED- 0I-34 OTSUKA 1 9,900 9,900

1 IV CAT-SURFLO 24 1 10,560 10,560

05/11 BEDAH ANDY 23093 KAEN 3B 2 15,423 30,846

1 SPUIT 10 CC TERUMO 4 2,027 8,108


.5/11 BEDAH ANDY 29033 INFUS SET PAED- 0I-34 OTSUKA 1 9,900 9,900

07/11 BEDAH ANDY 24950 SPUIT 10 CC TERUMO 3 2,027 6,081

1 SPUIT 5 CC TERUMO 3 1,848 5,544

07/11 BEDAH ANDY 24814 IV CAT-SURFLO 24 2 10,560 21,120

1 INFUS SET 0I-34 1 13,860 13,860

INFUS SPALK 4 X 15 1 8,527 8,527

08/11 BEDAH ANDY 24869 AMOKSISILIN SYR 125-INF 1 4,081 4,081

1 METROLET SYR 1 11,088 11,088

BHP 309,900 571,629

3 18-Dec BEDAH SURYA MN 27989 IV CAT-SURFLO 24 1 10,560 10,560 1,329,532


18/12-21/12 INFUS SET 0I-34 1 13,860 13,860

Abses a/n Femus RINGER LAKTAT-WB 1 5,220 5,220



18-Dec BEDAH MN 27992 CEFOTAXIM INJ 1 G-HXP 1 4,895 4,895







PROANES INJ 1 79,200 79,200









PENROSE DRAIN 5/8 1 78,000 78,000




19-Dec BEDAH AP 27830 CEFOTAXIM INJ 1 G-HXP 1 4,895 4,895






GLUKOSE 5 %-WD 1 4,247 4,247





21-Dec BEDAH ANDY 52137 AMOKSISILIN SYR 125-INF 1 4,081 4,081

1 METRONIDAZOL TAB 250-INF 6 102 612

PARASETAMOL SYR-INF 1 2,760 2,760

ANIOS ADP 55,000

IODINE 100 20,000



ALKOHOL 50 2,500

FORMALIN 10 500

ARP 1 25,500

CROMIC 2/0 1/2 4,900


LINAPEN 1 17,000

O2 0.5 4,400

N2O 0.25 31,500


BHP 71,400

1,329,532

TOTAL 3,300,501

Rata-rata 1,100,167

Tabel Biaya Pasien Soft Tisue TumorOktober-Desember 2012 RSUD Kota Bandung


1 16-Oct BEDAH SUNARNI ANDY 20611 NYLON 4/0 D5 18 SHARPOINT 1 56,100 56,100 1,156,910

2 MD.541559 INFUS SET 0I-34 1 13,860 13,860 JAMKEMAS

16/10-18/10 IV CAT-SURFLO 20 1 11,136 11,136

Soft Tisue Tumor RINGER LAKTAT-WB 1 5,220 5,220




GLUKOSE 5 %-WD 1 4,247 4,247




17-Oct OK YUDHIE 22176 PISAU BEDAH 15-AESCULAP 1 2,700 2,700






PROANES INJ 1 79,200 79,200











PENROSE DRAIN 5/8 1 78,000 78,000


ANIOS ADP 55,000

IODINE 100 20,000



CROMIC 2/0 1 9,800

ARP 1 25,500

JARUM 1 15,000

ALKOHOL 100 5,000

LINAPEN 1 17,000

O2 0.4 4,400

N2O 0.25 31,500


BHP 39,600

TOTAL 1,156,9102 7-Dec BEDAH WAWAN ANDY 27022 NYLON 3/0 D5 24 SHARPOINT 1 56,100 56,100 1,588,181


07/12-12/12 IV CAT-SURFLO 20 1 11,136 11,136

Soft Tissue Tumor IV CAT-SURFLO 22 1 11,136 11,136








PROANES INJ 1 79,200 79,200









PENROSE DRAIN 5/8 1 78,000 78,000





MILOZ INJ 15 ASKIN 1 14,310 14,310

8-Dec BEDAH AP 27069 CEFTRIAXON INJ 1 G-HXP 2 7,983 15,966





GLUKOSE 5 %-WD 1 4,247 4,247



9-Dec BEDAH ANDY 25762 CEFTRIAXON INJ 1 G-HXP 2 7,983 15,966





BETADIN 60 ML 1 21,054 21,054

10-Dec BEDAH SIMMAMORA 25808 CEFTRIAXON INJ 1 G-HXP 4 7,983 31,932





.11/12 BEDAH ANDY 26098 RINGER LAKTAT-WB 4 5,220 20,880

11-Dec BEDAH ANDY 26142 SPUIT 3 CC TERUMO 1 1,122 1,122

1 IV CAT-SURFLO 20 1 11,136 11,136

INFUS SET 0I-34 1 13,860 13,860



METOKLOPAMID TAB.-INF 15 140 2,100

ANIOS ADP 55,000

IODINE 100 20,000



CROMIC 2/0 1/2 4,900

ARP 1 25,500

FORMALIN 20 1,000

ALKOHOL 50 2,500

JARUM 1 15,000

LINAPEN 1 17,000

O2 0.5 4,400

N2O 0.25 31,500


BHP 126,000

8-Dec BEDAH MARHUM 41217 AMOKSISILIN 500 TABLET BERNO 15

METRONIDAZOL TAB 500-KF 15

ASAM MEFENAMAT TAB 500 INDO 15 16,000

TOTAL 1,588,181TOTAL 2,745,091

Rata-rata 1,364,455

Tabel Biaya Pasien Kista AteronOktober-Desember 2012 RSUD Kota Bandung


1 14/11 BEDAH ALIT ANDI 24330 ANIOS ADP 55,000 505,900

MD.151753 IODINE 150 30,000 SKM

14/11-16/11 WASH SCRUB 100 25,000

Kista Ateron KASA SILVER 3 14,700

CROMIC 2/0 2 19,600


FORMALIN 10 500

SILK 2/0 1 4,200

ARP 1 25,500

ALKOHOL 100 5,000

JARUM 1 15,000

LINAPEN 1 17,000

O2 0.5 4,400

N2O 0.25 31,500


BHP 51,000

505,900

59 11/12 BEDAH TATANG ANDY 26170 IV CAT-SURFLO 20 1 11,136 11,136 1,225,821


11/12-13/12 RINGER LAKTAT-WB 1 5,220 5,220

Kista Atheroma SPUIT 5 CC TERUMO 1 1,848 1,848

60 12/12 BEDAH ANDY 25876 NYLON 3/0 D5 24 SHARPOINT 2 56,100 112,200

61 12/12 OK YUDHIE 25894 PISAU BEDAH 15-AESCULAP 1 2,700 2,700



CROMIC 2-0 TAPER SURGIVEN 1 61,710 61,710

PROANES INJ 1 79,200 79,200








ONDANSENTRON INJ 8 MG IN 1 10,032 10,032


62 12/12 BEDAH ANDY 25934 CEFTRIAXON INJ 1 G-HXP 1 7,983 7,983






GLUKOSE 5 %-WD 1 4,247 4,247

63 13/12 BEDAH ANDY 25972 AMOKSISILIN 500 TABLET BER 15 446 6,690

ANIOS ADP 55,000

IODINE 100 20,000



ALKOHOL 100 5,000

FORMALIN 20 1,000

ARP 1 25,500

CROMIC 2/0 1 9,800


LINAPEN 1 17,000

O2 0.5 4,400

N2O 0.25 31,500


BHP 47,400

1,225,821

TOTAL 1,731,721Rata-rata 865,860

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